Office of Health Disparities Reduction Website

Tuesday, May 27, 2014

ACA's First Open Enrollment Period: Why Did Some People Enroll and Not Others?

A new survey conducted by PerryUndem Research/Communication and funded by the Robert Wood Johnson Foundation and The California Endowment, provides fresh insights into why some individuals enrolled in health coverage during the Affordable Care Act’s first open enrollment period and why some individuals did not.The survey, conducted April 10-28, 2014, among 671 newly enrolled individuals and 853 who remained uninsured, is the first in-depth examination of these populations and explores their attitudes, knowledge, and experiences with enrollment, costs, and health coverage.Key Findings

There was a high demand for health insurance during the Affordable Care Act’s first open enrollment period. Those who enrolled were willing to put time and effort into the process.

Those who enrolled had more information. For example, the newly enrolled were more than twice as likely to know about the availability of financial help to lowand moderate-income people than those who did not enroll (56% vs. 26%).

Individuals enrolled for many reasons, particularly the law/fine. As many as 40% indicate they might not have enrolled without the mandate. Other important motivations: being able to see a doctor and avoid big medical bills.

Many newly enrolled individuals felt enrolling was easy – but others faced difficulties. While 69% of the newly enrolled thought enrolling was “easy,” some of those who tried but did not enroll successfully found it confusing.

Three-quarters (74%) of the newly enrolled feel confident they can afford their premiums. They are also more than four times as likely to say their plans have enough doctors than not (56% vs. 13%).

Healthy people enrolled. The self-reported health status of those who enrolled and those who did not was similar.

Most of those who did not enroll (61%) wanted coverage. They wanted to enroll but could not find anything or say things got in the way of enrolling. Fifteen percent did not even know they could enroll. Only 15% did not want coverage.

Affordability concerns kept many away. The top reason why some people did not even look for coverage was the perception that they could not afford insurance.

Latinos and young adults (18-29) lagged behind in knowledge but wanted coverage. Latinos particularly valued in-person enrollment assistance. Young adults were more motivated by the fine than others.

More than eight in ten of the uninsured (84%) may be open to enrolling next time. Only 14% say they will not look for coverage.